Syphilis is a sexually transmitted disease (STD) caused by an infection with bacteria known as Treponema pallidum. Like other STDs, syphilis can be spread by any type of sexual contact. Syphilis can also be spread from an infected mother to the fetus during pregnancy or to the baby at the time of birth.

Syphilis has been described for centuries. It can cause long-term damage to different organs if not properly treated.

Syphilis infection, when untreated, progresses through different clinical stages with characteristic signs and symptoms. After the first infection, symptoms typically develop at around 21 days after the infection, but they may appear anywhere from 10 to 90 days following infection.

Primary syphilis

The first, or primary, stage of syphilis is characterized by the formation of a painless ulcer known as a chancre. This sore develops at the site of infection and is usually solitary. A chancre is usually firm and round in shape. Sometimes, multiple chancres may be present. The chancre contains infectious bacteria and while the sore is present, the condition is highly contagious. Any contact with the chancre can spread the infection. If the chancre is located in the mouth, for example, even kissing can spread the disease. The chancre lasts for about 3 to 6 weeks and typically then goes away on its own. The use of condoms may also not prevent the spread of the illness if the chancre is located on an area of the body not covered by the condom.

Secondary syphilis

If primary syphilis is left untreated, secondary syphilis may develop. This stage of the illness usually occurs weeks to months after the primary stage. Secondary syphilis is characterized by a skin rash that typically does not itch and may easily be mistaken for rashes caused by other illnesses. It may appear on almost any part of the body, including sores inside the mouth, vagina, or anus. The rash of secondary syphilis is often found on the palms of the hands and the soles of the feet, which is unusual for most rashes. In some people, the rash may be mild and not noticed. Raised gray or whitish patches of skin, known as condyloma lata, may also develop, particularly in warm and moist areas of the body such as the armpits, mouth, or groin.

In secondary syphilis, the infection has spread throughout the body, so other symptoms may be associated with the skin manifestations. Fever, Enlarged lymph nodes, fatigue, weight loss, hair loss, headaches, and muscle aches have all been reported in the secondary stage of syphilis. These symptoms will eventually subside, but if this secondary stage of the infection is not treated, the infection can progress to tertiary syphilis.

Tertiary syphilis

After the symptoms of secondary syphilis go away, the infection remains latent in the body if untreated. About 15% of infected and untreated people will go on to develop the third stage of syphilis, which can occur as much as 10 to 20 years after the initial infection. Tertiary syphilis is characterized by damage to any number of organ systems and can even be fatal. Tertiary syphilis can cause damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms that can result from the late stage of syphilis include problems with movement, gradual loss of sight, dementia, paralysis, and numbness. Neurosyphilis is the term used to refer to the involvement of the central nervous system and alterations in neurologic function.

Neonatal or congenital syphilis

Untreated syphilis in pregnant women results in the death of the fetus in up to 40% of infected pregnant women (stillbirth or death shortly after birth), so all pregnant women should be tested for syphilis at their first prenatal visit. The screening test is usually repeated in the third trimester of pregnancy as well. If infected babies are born and survive, they are at risk for serious problems including seizures and developmental delays. Fortunately, syphilis in pregnancy is treatable.

The bacteria that cause syphilis, Treponema pallidum, are referred to as spirochetes due to their spiral shape. The organisms penetrate into the lining of the mouth or genital area.

Penicillin is the treatment of choice for syphilis in all stages. One intramuscular injection of long-acting benzathine penicillin G (2.4 million units) is sufficient for a person who has primary, secondary, or early latent syphilis. Three doses of this drug at weekly intervals are recommended for individuals with late latent syphilis or latent syphilis of unknown duration. While treatment kills the bacteria and prevents further organ damage, it will not reverse damage to the organs that has already occurred. Treatment with penicillin is safe during pregnancy.

What are the potential complications of syphilis?

As mentioned, untreated syphilis spreads throughout the body and causes complications with various organ systems. Some of the better known complications of late syphilis include blindness, dementia, aortic aneurysm, deafness, stroke, and other complications related to spread of the infection to the brain. Late stage syphilis can cause fatal complications.

Untreated syphilis spreads throughout the body and causes complications with various organ systems. Some of the better-known complications of late syphilis include blindness, dementia, aortic aneurysm, deafness, stroke, and other complications related to the spreading of the infection to the brain. Late-stage syphilis can cause fatal complications.

When diagnosed and treated in its early stages, syphilis in women is easy to cure.

Cure/medications:
1. The preferred treatment at all stages is penicillin, an antibiotic medication that can kill the organism that causes syphilis. If you're allergic to penicillin, your doctor may suggest another antibiotic or recommend penicillin desensitization.
2. A single injection of penicillin is enough to combat all stages of syphilis. However, if you've had syphilis for longer than a year, you may need additional doses.
3. Penicillin is the only recommended treatment for pregnant women with syphilis. Women who are allergic to penicillin can undergo a desensitization process that may allow them to take penicillin. Even if you're treated for syphilis during your pregnancy, your newborn child should be tested for congenital syphilis and if infected, receive antibiotic treatment.
4. The first day you receive treatment, you may experience what's known as the Jarisch-Herxheimer reaction. Signs and symptoms include fever, chills, nausea, achy pain and a headache. This reaction usually doesn't last more than one day.

Treatment follow-up:
After you're treated for syphilis, your doctor will ask you to:
1. Have periodic blood tests and exams to make sure you're responding to the usual dosage of penicillin. Your specific follow-up will depend on the stage of syphilis you're diagnosed with.
2. Avoid sexual contact with new partners until the treatment is completed and blood tests indicate the infection has been cured.
3. Notifying the sex partners so that they can be tested and get treatment if necessary.
4. Be tested for HIV infection.

Symptoms
Primary syphilis: formation of a painless ulcer known as a chancre (a painless ulcer) that develops at the site of infection, and may spread when it comes to any type of contact,Secondary syphilis: a skin rash that appears inside the mouth, vagina, or anus that typically does not itch,Fever,Enlarged lymph nodes,Fatigue,Weight loss,Hair loss,Headaches
Conditions
Painless ulcer known as a chancre
Drugs
Penicillin (intramuscular injection of long-acting benzathine penicillin)